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'The present King of France', Russell maintained in On Denoting, seems to force us into either of the following positions. Either we follow Meinong but then infringe the law of contradiction, or posit senses beyond references, but we seem never able to genuinely talk about them. Hence, Russell urged, it is worth considering 'a somewhat incredible interpretation' of definite descriptions. This is his famous theory of descriptions, now not considered to be incredible anymore. In this paper we will investigate whether and, if so, how some of On Denoting's core claims can be applied not to the present King of France, but to propositions. We will see that following Russell on his considerations concerning the present King of France but not on parallel considerations concerning propositions and phrases that seem to refer to propositions is an unstable position, which Russell himself in On Denoting, and most of us today, seem to occupy. We will then discuss how to reach a more stable position. According to the account we will end up presenting, while there is some thing we believe when we believe truly, there is no thing we believe when we believe falsely. The account might look like a non-starter and goes against what Russell himself claimed. But, we will argue, we can find in On Denoting and in its theory of descriptions the resources to render such an account at least a bit less incredible.
Mobile devices enable individuals to efficiently and effectively complete instrumental activities of daily living (IADLs), and independence in IADLs is associated with a positive quality of life (QOL). While there may be barriers to adults with acquired communication disorders learning to use these tools, research supports their capability to do so successfully given proper support. Speech-language pathologists (SLPs) are qualified to deliver mobile device instruction given their unique skill sets in working with individuals with cognitive-linguistic, behavioral, sensory, and physical barriers. We present three case studies of individuals with acquired communication disorders after their participation in a specialty graduate student clinic focused on individualized mobile device training. Client records were examined retrospectively to investigate the impact of such training on independence in IADLs and QOL. The results of this endeavor resulted in positive outcomes in IADL completion and QOL across all participants. SLPs and related professionals are urged to incorporate mobile device instruction into their treatments when addressing client goals.
Acute intoxication is a series of pathophysiological changes or clinical manifestations over a short period (<24 hours) after exposure to toxic substances or toxic doses of drugs. Acute domestic poisoning is a preventable cause of morbidity and mortality among children, with a higher burden in low- and middle-income countries. This study aims to enhance the understanding of this public health problem and its complications, thereby promoting timely interventions, preventive strategies, and ultimately reducing mortality. A 5-year retrospective cohort study from 2019 to 2023 including 242 children aged 0-15 years hospitalized for acute domestic intoxication at Bamenda Regional Hospital, Nkwen District Hospital,Saint Mary Catholic Hospital and Saint Blaise Catholic Hospital. Two hundred fifty-four cases of acute intoxication out of a total of 16 456 admissions were noted, giving a prevalence of 1.5% of admissions. Children were predominantly male (56.6%), with the 3-7 age group the most represented (33.1%). Toxic substances were mainly pesticides (19.0%), hydrocarbons (14.9%), and drugs (13.2%). Clinical manifestations were dominated by digestive (57.0%), neurological (34.3%), and respiratory (13.2%) symptoms. At home, the parents had given the child palm oil (46.3%) or charcoal (25.9%). A total of 9 deaths were recorded, representing a case-fatality rate of 4.2%, with a favorable clinical outcome in 95.8% of cases. Acute domestic poisoning remains frequent and a major pediatric emergency for children in the context. Parents are urged to keep toxic products out of their children's reach and to seek appropriate medical attention in the event of intoxication. Cite this article as: Chiabi A, Djoudja KR, Kan K, et al. Epidemiology, clinical profile, and outcome of acute domestic poisoning in children in four health facilities in the north west region of Cameroon. Eurasian J Med. 2026, 58(2), 0885, doi: 10.5152/eurasianjmed.2026.25885.
Regulated healthcare markets rely on provider competition to improve efficiency and access. During the COVID‑19 pandemic, Dutch hospitals were urged to prioritise emergency COVID care, while independent treatment centres (ITCs) were largely exempt. This reallocation of capacity substantially reduced hospitals' ability to deliver elective gynecological care and may have affected medium‑run market dynamics between provider types. This study examines how the COVID-19 pandemic affected revenues, treatment volumes, and surgical care proportions in benign gynecological care across different provider types in the Netherlands over time. We used nationwide monthly claims data from 2016 to 2022 covering all Dutch hospitals. Focusing on six common gynecological care pathways, we assessed changes before, during, and after the initial COVID-19 shock. Regression models with hospital and care-path fixed-effects were used to estimate the impact of the immediate COVID-19 shock and the subsequent COVID-adjustment period, distinguishing between academic, top-clinical, general hospitals, and ITCs. All provider types experienced an initial revenue decline during the COVID-shock, with general hospitals most affected. ITCs saw smaller losses and rebounded strongly, increasing their revenue by 23.62% and surgical care share by 21.34% relatively. In contrast, general, top-clinical and academic hospitals, responsible for emergency COVID care, suffered deeper, more persistent losses. Providers exempt from emergency COVID-19 care showed different adjustment trajectories than hospitals delivering emergency services, with prolonged implications for their relative market positions up to 2022. This indicates that crisis conditions can affect market dynamics and should be explicitly considered when shaping emergency response policies.
DNA testing methods have become incredibly sensitive. Many court stakeholders have accordingly shifted their focus from questions about "who is the source of the DNA?" to "how did the DNA get to be where it was found?" Given this shift, some in the forensic DNA community have urged courts in the United States to permit testimony interpreting DNA evidence given activity-level propositions (ALP). These advocates assert that ALP reporting and testimony will "help" courts answer the relevant questions in their cases. This assertion requires scrutiny. Examinations of wrongful convictions teach us that forensic experts can do irreparable harm when attempting to help courts answer difficult questions. The potential that ALP reporting and testimony will contribute to miscarriages of justice in U.S. courts must be considered. The commentary in this article critically assesses the claim that ALP reporting and testimony will help courts in the United States reach the correct outcome. We do so by analyzing an activity-level "lookup table" that was recently published by advocates of ALP reporting in a paper titled Interpreting DNA under fingernails given activity level propositions. Our analysis considers the potential that LRs reported in the lookup table will mislead end-users. We also consider the vulnerability of U.S. courts to wrongful convictions based on overstated forensic science testimony. Our analysis ultimately reveals that application of the lookup table to casework in the United States may not help end-users reach the correct outcome, and may, in fact, increase the risk of wrongful convictions.
Breathlessness is prevalent in fibrotic-interstitial lung diseases (F-ILD) but remains underrecognised and undertreated. The purpose of this study was to examine perceptions of visibility of breathlessness among healthcare professionals experienced with managing patients with F-ILD. Four focus groups and three key-informant zoom interviews were held with 28 multinational participants from diverse practice settings and health disciplines. Using a qualitative inductive approach, themes were developed and confirmed through open coding and ongoing content analysis. The inevitability and invisibility of breathlessness in F-ILD were central and continuous throughout the three themes of the study: invisibility and visibility of breathlessness; complexity of breathlessness assessment; and becoming aware and prioritising breathlessness. Patients normalise and adapt to minimise their breathlessness. Exertional breathlessness and hypoxaemia are less understood by clinicians, friends, and family, contributing to its invisibility. Symptom assessment and management are complex and limited, reliance may be through an objective lens. There is a need for an easy-to integrate tool to assess and manage breathlessness. All participants were unprepared by their initial education to recognise or prioritise breathlessness as a symptom. Some sought specific training, most gained competency and awareness through role modelling and mentorship from experts. These healthcare professionals did not accept breathlessness as inevitable in F-ILD and urged others to not ignore it. Our study suggests perceptions of the invisibility and inevitability of breathlessness in F-ILD can change. Management of breathless patients can improve through awareness, education and training.
Heart failure (HF) remains a major public health challenge in Asia, with rising prevalence and disability burden. This study analyzed data from the 2021 Global Burden of Disease study (GBD 2021) to assess HF trends across 48 Asian countries from 1990 to 2021. In 2021, there were 29.5 million HF cases in Asia, a 155% increase since 1990, with an age-standardized prevalence rate rising from 583.62 to 633.76 per 100,000. Years lived with disability (YLDs) also surged by 155%, reaching 2.86 million in 2021. China accounted for 44.34% of Asia's HF cases, with the highest YLDs. Treated HF cases were most common, but severe HF contributed most to YLDs. The middle-high socio-demographic index (SDI) region had the highest age-standardized prevalence rate, while most SDI regions saw increasing trends, except Japan and Cyprus. The findings highlight the growing HF burden in Asia, urging targeted interventions to address this escalating health crisis.
This commentary, from a Point/Counterpoint on the role of photon-counting CT in pediatric imaging, argues that the technology’s adoption is inevitable when considering the improved image quality, radiation dose reductions, and multidimensional imaging capabilities. Pediatric radiologists are urged to embrace this transformative paradigm shift in CT technology.
To assess prostate biopsy uptake and its associated factors among patients previously found to have elevated Prostate-Specific Antigen results at the Kyabirwa Surgical Center (KSC). An analytical cross-sectional design was employed to study 52 male patients with elevated PSA levels (> 10 ng/mL) at the Kyabirwa Surgical Center. They were consecutively sampled, located in their areas of residence, and engaged in structured interviews. Data were collected and analyzed descriptively using SPSS version 26, with a log-binomial model for relationship analysis. The proportion of patients with elevated PSA levels at the KSC who underwent prostate biopsy was 55.8%, with most having their biopsies performed at the center (72.4%). Perceived good health status (aPR = 0.368¸95% CI = 0.155-0.877, p = 0.024) lowered the prevalence of uptake. However, educating patients about prostate health KSC (aPR = 2.150, 95% CI = 1.157-3.995, p = 0.015), the cost of a prostate biopsy (aPR = 2.647, 95% CI = 1.374-5.099, p = 0.004), the meaning of PSA results (aPR = 2.647, 95% CI = 1.374-5.099, p = 0.004), the importance of a biopsy, how it is performed (aPR = 2.078, 95% CI = 1.137-3.798, p = 0.016), and being followed up by healthcare workers at KSC to determine compliance with the instructions to perform a biopsy (aPR = 1.603, 95% CI = 1.074-2.394, p = 0.021) were associated with a higher prevalence of biopsy uptake. Only half of the patients who have elevated Prostate-Specific Antigen levels at the Kyabirwa Surgical Center and are advised to have a prostate biopsy done, go ahead and undergo biopsy. Only a few of them still have the biopsy done at other facilities, further emphasizing the fact that prostate cancer screening behavior is poor among men who are urged to undergo screening via biopsy by the KSC staff. The negative factors associated with prostate biopsy uptake are patient-related, while all positive factors associated with biopsy uptake are institutional and specifically related to post-test patient education.
Voice disorders affect nearly one in three people during their lifetime and are associated with significant reductions in quality of life. Despite this, limited research has explored the experiences of adults living with voice disorders. This review synthesizes patient-reported experiences and impacts of voice disorders in adulthood. Six databases (PubMed, CINAHL, Web of Science, Embase, Cochrane, and Scopus) were systematically searched, and studies were screened using an established scoping review framework. The included studies were analyzed following recognized principles of qualitative meta-synthesis. From 3525 studies identified, six met study inclusion criteria and underwent thematic synthesis. Five overarching themes emerged: 1) My voice doesn't sound or feel like it used to; 2) My voice disorder has diminished my emotional well-being and self-confidence; 3) My voice disorder impacts my life participation; 4) Stigma hurts, support helps; 5) Living with my voice disorder means learning to adapt. Recurring themes surrounding psychosocial well-being and life participation restriction highlight the need for clinicians to develop counseling skills and knowledge of when and how to refer for additional support. Clinicians are urged to use a more holistic approach to voice assessment and treatment, acknowledging that the impacts of voice disorders often extend well beyond the larynx.
The clinical significance of one or two measurable residual disease (MRD) assessments is established in multiple myeloma (MM). However, how to stratify patients according to ≥3 MRD assessments remains unknown. The traits of MRD resistance and if treatment of persistent MRD vs relapse could improve outcomes also remains unknown. MRD dynamics were computed using next-generation flow cytometry and Connector in 539 newly-diagnosed MM patients with ≥3 assessments in the GEM2012MENOS65/GEM2014MAIN and GEM2017FIT trials. Molecular and immune profiling were performed in matched diagnostic and MRD samples. The survival impact of treating persistent MRD vs relapse was investigated with anti-BCMA CAR T cells in MIcγ1huCRBN mice. Computed MRD dynamics based on 3,610 MRD assessments identified five subgroups with different survival. Patients with late-sustained MRD response had excellent outcomes, similar to those with early-sustained MRD response. Patients with volatile results and those with primarily and resurgent MRD resistance had dismal survival. MRD dynamics outperformed transplant-eligibility and the R-ISS. These results were validated in 249 MM patients treated in routine practice. Multiomics characterization of MRD dynamics in patients and mouse models of MRD resistance revealed genomic evolution, transcriptional adaption and a pro-inflammatory tumor-immune microenvironment. Increasing clonality and exhaustion of endogenous T cells throughout disease progression urged investigating if MRD interception with anti-BCMA CAR-T cells could improve outcomes. Infusion at MRD resistance prolonged mouse survival compared to identical treatment at relapse. Altogether, MRD dynamics is the strongest predictor of progression and may help tailoring treatment to prevent additional tumor and immune alterations prior to relapse.
This comment outlines the author´s experience with a submission to the Pan African Medical Journal. Twenty-two months after submission, the manuscript remains in review, and no first decision from the journal has been received. The author urges the editorial office to put measures in place to ensure that other authors do not have a similar experience.
This JAMA Insights discusses sleep and obesity and urges clinicians to address sleep health and, indirectly, address obesity prevention and treatment by asking patients about their sleep quality and quantity.
Hemomania is a proposed term for incontrollable urges to see, release, or ingest blood which is not a formally recognized diagnostic entity. This behavioral phenomenon overlaps with nonsuicidal self-injury (NSSI), impulse control disorders, and elements of clinical vampirism. We present the case of a 22-year-old female with a longstanding history of bloodletting using syringes, blood ingestion, and collection. The patient collected blood in vials, sometimes mixed them with water and drank it. She also collected and consumed blood from other individuals and animals occasionally. These behaviors did not align with existing diagnostic categories, therefore, conceptualized within the proposed construct of hemomania. She had comorbid major depressive disorder with psychotic features, borderline personality disorder (BPD), and schizotypal traits. Her problems intensified following recent marital discord, which acted as a key emotional trigger. Treatment comprising pharmacotherapy and psychotherapy resulted in partial improvement of symptoms but relapsed within a few months. This case describes an atypical, chronic presentations of exceptionally rare pattern of behavior and highlights the conventional diagnostic and therapeutic challenges underscoring the need for precise diagnostic framing, thorough differential assessment, and individualized treatment approaches for such complex psychiatric presentations.
In the early stages of pertussis, timely initiation of effective antibacterial treatment (including prophylactic medication before symptom onset) can halt disease progression. In China, where measures such as maternal immunization are currently lacking, this remains a crucial approach to preventing severe illness and death from infant pertussis. However, a clear and unified time-based standard defining this "early stage" is lacking, and few studies focus on diagnostic strategies targeting early treatment. Based on the natural disease course of pertussis and limited clinical evidence, a time criterion of within 7 days from illness onset is proposed in this article for early diagnosis of pertussis. Strategies to promote early diagnosis are discussed: raising public awareness to encourage early medical consultation for infant pertussis; enhancing clinical recognition to facilitate early suspicion and testing; emphasizing the cough history of close contacts; identifying early clinical features such as the triad of afebrile status, rhinorrhea, and cough; noting significant increases in white blood cell count and/or lymphocyte proportion in routine blood tests; prioritizing etiological methods for diagnosis or exclusion; and urging health authorities to establish coordinated active surveillance and screening mechanisms between hospitals and disease control institutions. This article aims to support clinical research, standardize early diagnosis, antimicrobial treatment, and chemoprophylaxis of pertussis, and ultimately minimize severe cases and deaths in infants. 在百日咳病程早期及时启动有效抗菌治疗（包括在发病前进行药物预防）能够阻止疾病进展，是我国当前尚缺乏孕期免疫等措施的情况下，预防婴儿百日咳重症和死亡的重要手段。但对此“早期”却一直缺乏明确统一的以病程时间判断的标准，少见以此“早期”治疗为目标的“早期”诊断策略的研究报告。该文基于百日咳自然病程及有限的临床证据，提出了以病程7 d内为百日咳早期诊断的时间标准，并探讨了促进百日咳早期诊断的策略:提升公众对婴儿百日咳的警惕性以促进早期就诊;提升临床认识促进早期疑诊及检测;重视密切接触者咳嗽史;识别“三联征（无热、鼻炎卡他、咳嗽）”等早期临床特征;注意白细胞计数和/或淋巴细胞比例显著增高等血常规变化;优先使用病原学方法进行诊断或排除诊断;管理部门应组织构建医院与疾病预防控制机构协同的主动监测筛查等机制。该文旨在通过探讨百日咳早期诊断的时间标准与促进策略，以期推动临床相关研究，促进百日咳早期诊断、药物治疗和预防的规范化，尽可能避免婴儿百日咳重症和死亡。.
Chikungunya virus (CHIKV) has emerged as a globally important arthropod-borne pathogen with rapid geographical expansion, urging high-performance yet simple diagnostic tools. Herein, we develop an isothermal dual-engine amplification biosensor by integrating catalytic hairpin assembly (CHA) with CRISPR-Cas12a for ultrasensitive and rapid detection of CHIKV RNA. This strategy combines the enzyme-free isothermal amplification of CHA and the high-specificity trans-cleavage activity of CRISPR-Cas12a to realize cascade signal enhancement. By systematically optimizing reaction parameters including probe ratio, temperature, buffer, and incubation time, we achieve superior analytical performance. The biosensor exhibits a low limit of detection of 4 fM, a wide linear range from 10 fM to 1 μM (R2 > 0.98), and excellent specificity against dengue virus, Zika virus, and other common blood-borne viruses. It also shows strong resistance to interference from hemolysis, icterus, and lipemia. The whole assay can be finished within 60 min under isothermal conditions without sophisticated thermal cyclers. In clinical serum samples, this method achieves 97.5% concordance with RT-qPCR, with a sensitivity of 96.8% and a specificity of 100%. This CHA-CRISPR-Cas12a dual-amplification platform provides a sensitive, specific, rapid, and cost-effective approach for CHIKV detection and holds great promise for point-of-care testing in resource-limited settings.
Septic pulmonary embolism in adults is usually associated with right-sided endocarditis. We report a 27-year-old male with 14 days of fever, dyspnea, and hemoptysis. CT chest showed bilateral peripheral cavitating nodules consistent with septic pulmonary emboli. Blood cultures yielded MRSA; transesophageal echocardiography showed no vegetations. CT abdomen-pelvis identified a thrombus in the inguinal venous system compatible with septic thrombophlebitis. Management included IV antibiotics and anticoagulation. His case highlights the close interplay between septic thrombophlebitis and infective endocarditis. As well as the utility of prompt extra-thoracic imaging when endocarditis work up is negative. Central discussion points include the devastating consequences of persistent bacteremia, urging the clinician to take action and the controversial use of anticoagulation for septic pulmonary embolism, which in this case was completely beneficial.
Sports wagering is associated with alcohol use and alcohol-related harm, and gambling can increase alcohol consumption and drinking urges. However, the effect of sports wagering on alcohol reward value remains unclear. The present study explored the interactive effect of placing a single-event sports wager and social context on alcohol demand (a behavioral economic measure of alcohol reward value) using context-adapted alcohol purchase tasks in a sample of individuals reporting past-month alcohol use and sports wagering (n = 425; Mage = 31.28; 71.29% male). Contrary to hypotheses, there were no differences in alcohol demand between context-adapted alcohol purchase tasks as a function of concurrent sports wagering (padj = .876-.924) or social context (padj = .170-.667). Exploratory analyses investigated relations between gambling motives and alcohol demand and the relations between various behavioral economic constructs and problem gambling. Omax was associated with an increased likelihood of problem gambling (OR = 1.02, padj = .03). Omax and elasticity were associated with financial gambling motives, but less so during concurrent gambling events, with concurrent sports wagering attenuating the relation between elasticity and financial motives (b = 0.34, padj = .003). Financial motives for gambling were positively associated with alcohol use broadly, but not with simultaneous drinking while gambling. These findings suggest relations between sports wagering and alcohol demand are complex-highlighting the need for future research into the sports wagering experience, specific sports wagering forms, and alcohol's role in sports culture to better understand the relation between alcohol use and sports wagering. (PsycInfo Database Record (c) 2026 APA, all rights reserved).